Brain and Behavior -- Syllabus

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Brain & Behavior|Syllabus 2016

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Brain & Behavior |2016

Course Syllabus

Course description

Brain & Behavior explores the functional organization and neurophysiology of the central nervous

system, and the neurobiological foundation for understanding disorders of human behavior. This course

employs a variety of instructional methods and learning experiences, including video tutorials, problem

solving through clinical cases, instructor-facilitated discussion, live tutorials and seminars from expert

scientists and clinicians, patient-interviews, and hand-on examination and dissection of human brain

specimens. In-class learning will be organized around the principles of team-based learning, with students

organized in small teams for Readiness Assurance, Team Applications and Laboratory Discovery. The

overall goal of this course is to provide the foundation for understanding the integrative actions of the

nervous system and the impairments of sensation, action and cognition that accompany injury, disease

or dysfunction in the central nervous system. The course will build upon knowledge acquired in Molecules,

Cells & Tissuesand Normal Body, and it will provide a framework for understanding the neurological basis

for the physical examination and the pathophysiological considerations that are featured in Body &

Disease.

Course directors

Leonard E. White, PhD (primary course director)

Associate Professor

Orthopaedic Surgery; Neurobiology

Duke Institute for Brain Sciences

[click here for professional profile]

Andrew Krystal, MD

Professor

Psychiatry and Behavioral Sciences (Outpatient Psychiatry)

http://www.dibs.duke.edu/research/profiles/23-leonard-whitehttp://www.dibs.duke.edu/research/profiles/23-leonard-whitehttp://www.dibs.duke.edu/research/profiles/23-leonard-whitehttp://psychiatry.duke.edu/faculty/details/0040792http://psychiatry.duke.edu/faculty/details/0040792http://psychiatry.duke.edu/faculty/details/0040792http://psychiatry.duke.edu/faculty/details/0040792http://www.dibs.duke.edu/research/profiles/23-leonard-white


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Eric Thompson, MD

Assistant Professor

Neurosurgery; Pediatrics

Duke Cancer Institute


Course objectives

At the completion of this course the student will:

1.

Demonstrate the major embryological subdivisions of the central nervous system as seen on the

surface of the human forebrain, hindbrain and spinal cord.

2. Demonstrate the four lobes of the cerebral hemispheres in the human brain, including the

neuroanatomical landmarks that define their boundaries.3. Sketch the lateral and medial views of the cerebral hemispheres of the human brain, with all

primary gyri and sulci of the human cerebral cortex identified.

4. Discuss the major, clinically significant functions that are localized to each of the four pairs of

lobes in the cerebral hemispheres of the human brain.

5. Describe the means for blood supply to the brain and spinal cord, including the principle vessels

that supply each of the major subdivisions of the central nervous system.

6. Identify internal components of the central nervous system in cross-sectional preparations and

histological presentations, including ventricular spaces, major white matter structures and deep

gray matter structures.

7.

Sketch the organization of deep gray matter in the human forebrain relative to the ventricular

system and major white matter structures.

8. Describe the organization of the major ascending and descending tracts of the brain and spinal

cord, including neural systems for pain and temperature sensation, touch and pressure

sensation, motor control, and vision.

9. Describe the location and function of the major neuroanatomical structures involved in motor

control and sensory processing.

10.Discuss the major systems in the central nervous system for maintaining homeostasis,

promoting allostasis, and governing the functions of visceral motor effectors.

11.Discuss the mechanisms responsible for axon guidance, synapse formation and developmental

plasticity in the central nervous system.

12.Discuss the functional impairments associated with injury or disease affected major sensory and

motor structures in the forebrain, hindbrain and spinal cord.

13.Describe the neural mechanisms that regulate sleep and wakefulness.

14.Discuss the neurobiological mechanisms of emotion, reward and motivation.

15.Discuss the neurobiological mechanisms of stress and anxiety.
https://scholars.duke.edu/display/per1265162https://scholars.duke.edu/display/per1265162https://scholars.duke.edu/display/per1265162https://scholars.duke.edu/display/per1265162


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16.Discuss the brain mechanisms that support and modulate attention, executive function, and

decision-making.

17.Describe major forms of anxiety, mood, and personality disorders.

18.Discuss the functional impairments associated with injury or disease affected major cognitive

systems in the forebrain and hindbrain.

Learning resources

We will mobilize and employ a variety of instructional resources for this course, including:

Bluedocs websitefor Brain & Behavior[check frequentlydailyfor announcements, updates to

schedule, and information pertaining to each learning event including session objectives]

Sakai websitefor Brain & Behavior[for daily TBL assessments and scores] (click here)

Medical Neurosciencewebsiteon Coursera (click here)[participation is OPTIONAL; cost is FREE]

primary textbook: Purves D, Augustine GJ, Fitzpatrick D, Hall WC, LaMantia A-S, McNamara JO,

White LE (2011) Neuroscience, 5thEd.Sunderlund MA: Sinauer Associates, Inc.

cost: hardcopy: $100.26 (bundled with Sylvius4 Online)

loose-leaf: $65.17 (bundled with Sylvius4)

CourseSmart eBook: $53.08 (6 month digital rental)

supplemental reader: White LE and Cant NB (2016)A Laboratory Guide for Learning Functional Human

Neuroanatomy.

cost: hardcopy distributed gratisto enrolled users

(printed compliments of the Office of Curriculum Affairs and the

Duke Institute for Brain Sciences)

PDF available on Bluedocsand Sakai

reference media: Williams SM, White LE (2013) Sylvius4 Online: An Interactive Atlas and Visual

Glossary of Human Neuroanatomy. Sunderlund MA: Sinauer Associates, Inc.

cost: bundled with purchase of Neuroscience, 5thEd.

without Neuroscience, 5thEd.,free when accessed via Duke Health

i.p. address (50 simultaneous users enabled)

$25 (one-year subscription)
https://sakai.duke.edu/https://sakai.duke.edu/https://sakai.duke.edu/https://www.coursera.org/course/medicalneurohttps://www.coursera.org/course/medicalneurohttps://www.coursera.org/course/medicalneurohttps://www.coursera.org/course/medicalneurohttps://sakai.duke.edu/


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recommended text: Blumenfeld H (2010) Neuroanatomy through Clinical Cases, 2nd Edition.

Sunderlund MA: Sinauer Associates, Inc.

cost: $74.76 (hardcopy)

CourseSmart eBook: $40.48 (18 month digital rental)

YUZU eBook: $35.43 (180 day digital rental)

BryteWave eBook: $40.48 (180 day digital rental)

Instructional methods

We will employ a variety of instructional methods to enhance your learning experiences in this course.

Traditional teaching methods will include in-class tutorials/seminars and active laboratory experiences.

Additional methods will employ the principles and practices of team-based learning, including individual

and team Readiness Assurances (iRAs and tRAs, respectively) and Team Applications, during which you

will problem-solve and promote collaborative learning among the members of your team. In addition,

video tutorials, tutorial notes, and assigned readings and animations from Purves et al., Neuroscience 5th

Ed.and the Laboratory Guide, will provide structure for individual and team learning in advance of each

class session.

Course policies

Requirements. Each learner and instructor is expected to uphold theDuke Community Standardin all

academic and non-academic endeavors associated with this course.

Duke University is a community dedicated to scholarship, leadership, and service and to the

principles of honesty, fairness, respect, and accountability. Citizens of this community commit

to reflect upon and uphold these principles in all academic and non-academic endeavors, and to

protect and promote a culture of integrity.

To uphold the Duke Community Standard:

I will not lie, cheat, or steal in my academic endeavors;

I will conduct myself honorably in all my endeavors; and

I will act if the Standard is compromised.

This Standard emphasizes dedication to scholarship, leadership, and service, and to the principles of

honesty, fairness, respect, and accountabilityall values that we will uphold in our studies of Brain &Behavior. Furthermore, all medical students are bound to uphold the Duke University School of

Medicine Code of Professional Conduct.

Readiness Assurances. Each learner will come to class having prepared for the days activities, be they

faculty-led tutorials and seminars, laboratory experiences, team discussions or team applications.

Readiness Assurances(RA) are designed to encourage you to meet this expectation. RAs will sample your

knowledge of core, foundational content that you will be expected to study and learn outside of the
http://studentaffairs.duke.edu/conduct/about-us/duke-community-standardhttp://studentaffairs.duke.edu/conduct/about-us/duke-community-standardhttp://studentaffairs.duke.edu/conduct/about-us/duke-community-standardhttp://medschool.duke.edu/education/office-student-affairs/code-professional-conducthttp://medschool.duke.edu/education/office-student-affairs/code-professional-conducthttp://medschool.duke.edu/education/office-student-affairs/code-professional-conducthttp://medschool.duke.edu/education/office-student-affairs/code-professional-conducthttp://medschool.duke.edu/education/office-student-affairs/code-professional-conducthttp://studentaffairs.duke.edu/conduct/about-us/duke-community-standard


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classroom through the use of through video tutorials, assigned readings, and other digital resources. You

should expect a Readiness Assurance on nearly a daily basis (as scheduled in Bluedocs). You will take these

assessments first on an individual basis (called an individual Readiness Assurance; iRA), and then again as

a team (called a team Readiness Assurance; tRA). Thus, following the iRA, you will have the opportunity

in real time to consolidate your knowledge, fill-in any gaps, and improve your understanding of the

foundational material; this will set the stage for the applied learning that follows. You will also have the

opportunity to improve your overall performance on the sessionsRAby working with other members of

your team on the tRA. iRAs/tRAs will typically comprise 15-25, multiple-choice questions. As the course

progresses, the number of questions will increase slightly as questions from previous iRAs/tRAs will be

incorporated to assess your retention of cumulative course material. Each RAsession will last, on average,

about 50 minutes. This will include facilitated discussion among teams as well as clarifying input from your

course instructors. During each RAsession, all questions in both phases of the RA (iRA/tRA) are to be

completed without the aid of any external sources (i.e., closed book and closed internet). As a significant

percentage of your score on each assessment will be determined by your teams performance(see below),

you have a strong incentive to work together effectively as a team both in and out of the classroom setting.

Applications. Following the Readiness Assurance process, you will be challenged on a daily basis to apply

your knowledge through a variety of learning experiences. These will include laboratory-based

explorations of neuroanatomy using human brain specimens, in-class demonstrations, neurobiological or

clinical seminars on topics of special interest, and clinical presentations with patient interviews.

Application of core knowledge will also be facilitated by structured Team Applications (TA), which are

designed around clinical cases from the neurology practice of Dr. Hal Blumenfeld (MD, PhD), as presented

in Blumenfeld (2010), Neuroanatomy Through Clinical Cases, 2nd Ed., or cases from the practice of

neurologists at Duke Hospitalmost notably from the practice of Dr. Talmage L. Peele (MD). TAsessions

require mobilization and application of foundational contentfrom previous weeks of study in the course,

but no specific preparation by you ahead of time (other than review and study of cumulative coursecontent). During TAsessions, you will work in your teams to master a concept or series of concepts or to

address the neuroanatomical bases for a specific set of presenting clinical signs and symptoms. Typically,

TAsessions will be open resource.

Self/Peer Assessment. To succeed in your learning throughout

Brain & Behaviorit will be essential to exercise the LEAD (Leadership,

Education and Development) model for leadership in healthcare.

This requires personal responsibility, accountability, and a desire to

receive constructive feedback from your teammates. To promote

optimal teamwork as you move forward in the curriculum in the MS1year, team members will assess one anothers contributions to the

functioning of the team near the midway point of Brain and

Behavior. This process will be directed and implemented by the LEAD

curriculum for first-year medical students. You will begin with a self-

assessment, and then for each team member, you will be asked to

respond to a brief survey that is designed to assess cooperative learning skills, self-directed learningand


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interpersonal skills. This procedure is designed to encourage reflection, introspection, evaluation and

professional formation. During the process of facilitated discussion with teammates, please do

communicate openly, graciously, and constructively as potential challenges to team effectiveness arise,

so that they can be quickly identified, and appropriate strategies for improvement can be implemented

before the conclusion of this course.

Team membership. To facilitate the formation of highly functional teams of learners for team-based

learning activities, MS1 students have been assigned to teams of 5-7 learners each by the Office of

Curricular Affairs, Duke University School of Medicine. Please note, there is no option for changing teams.

Teams have been and will continue to function according to the formstorm norm perform

model, meaning that some friction among teammates is to be expected as part of the process required

for normalizing the contributions of all team members and achieving a high level of team performance.

Problems within teams should be dealt with within the team. Individual contributions to team success can

and should be governed by team members. The course directors and the Office of Curricular Affairs may

facilitate resolution of conflict within a team, but only after teams have exhausted their capacity to do so

on their own.

Attendance. Given the compressed timeframe for Brain & Behaviorin the MS1 curriculum (just 19 days

in January 2016, and then the final exam day!), attendance of all course sessions is encouraged in the

strongest terms. However, illness, family emergencies, and other legitimate life-events occur that require

your presence elsewhere. When such events do occur, you must inform the primary course director in

advance of the learning event or as soon as possible thereafter. Excused absences from Readiness

Assurances will be remediated by completion of the individual Readiness Assurance via a time and

mechanism to be determined by the primary course director and Office of Curricular Affairs staff.

However, it is simply not possible to recreate teamwork (team Readiness Assurances, Team Applications,

laboratory experiences, etc.) when an absence occurs. Therefore, absences will result in no points earnedby the absentee for the team components of those learning events.

Out of respect and appreciation for the generosity of our guests, course sessions with patient interviews

are coded in Bluedocs as mandatory. Likewise, the exam on February 1stis mandatory(for obvious

reasons). All other course sessions are coded as optional(non-mandatory), with the understanding

that it is up to the learners to decide how best to apply their efforts in the course, given the course policies

outlined here. Please refer to Bluedocs for the updated list of learning events that involve some form of

assessment (Readiness Assurance; Team Application).

Grading. The assessment strategies for this course will be weighted as follows:

Individual

Assessment

Team

Assessment Percentage of Final Grade

Readiness Assurances 50% 50% 50%

Team Applications --- 100% 25%

Final Exam (NBME) 100% --- 25%


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The distribution of weight between iRAand tRAmeans that 50% of the final grade for the course is

achieved on the basis of individual work, and 50% is based on teamwork.

There is a final exam in Brain & Behavior. This year, as was the case last year, the final will take the

form of a customized exam selected from a pool of retired USMLE Step 1 questions. This exam will be

accessed via a website managed by the National Board of Medical Examiners (NBME). This experience isdesigned to assist you in gaining experience with NBME questions and logistics, as well as to assess your

cumulative knowledge of neurophysiology, clinical neuroanatomy and biological psychiatry.

Please note: in order to achieve a passing grade in Brain & Behavior, you must obtain a score of 60%

or greater on the individual component of the final exam. Failure to achieve this minimal competency

standard will result in ONE opportunity to remediate, which must be done before the start of Body &

Disease(or at a time appointed by the primary course director). The overall passing standard for Brain

& Behavioris a final course score of 70% or greater.

Course calendarTopic outline. The following table provides a session-by-session listing of topics to be covered in

Brain & Behavior, as well as video tutorials and assigned readings for preparation in advance of the

course session. The topic list in the table provides the daily structure for the learning sequence;

however, changes may be made by the course directors as the course progresses to facilitate

achievement of course objectives, as well as to manage any emerging contingency (e.g., inclimate

weather; clinical emergencies, etc.). Please rely on Bluedocsas your primary calendar for the learning

events in Brain & Behavior.

DAY TOPIC TBL EVENT ASSIGNED READINGSVIDEO

TUTORIALS

1

[Jan. 4]

Course overview &

Embryological

Subdivisions of the

Brain

iRA/tRA

Hands-On

Application

Laboratory Guide, Lab 1

00_0000_05

01_01, 01_04, 01_07

& 05_01

2

[Jan. 5]

Cerebral Cortex &

Brain Blood Supply

iRA/tRA

Hands-On

Application

Laboratory Guide, Lab 2 01_0501_11

3

[Jan. 6]

Synaptic Transmission& Postsynaptic

Mechanisms

iRA/tRAClinical

Application

Neuroscience, 5thEd.,

Chapters 5-7

02_1002_17

(for additionalbackground, view

01_02, 01_03 &

02_0102_09)

4

[Jan. 7]

Sectional Anatomy of

the Brainstem and

Spinal Cord

iRA/tRA

Hands-On

Application



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TUTORIALS

5

[Jan. 8]

Cranial Nerve Nuclei

and Neuromodulatory

Nuclei of the

Brainstem

iRA/tRA

Hands-OnApplication


6

[Jan. 11]

Somatic Sensation &

Pain

iRA/tRA

Clinical

Application


Chapters 9-10; Laboratory

Guide, Appendix 1

03_0603_16

(for additional

background, view

03_0103_05)

7

[Jan. 12]

Auditory & Vestibular

Systems; Chemical

Senses

iRA/tRA

Clinical

Application


Chapters 13-1503_2903_50

8

[Jan. 13] Vision

iRA/tRA

ClinicalApplication


Chapters 11-12; LaboratoryGuide, Appendices 2 & 5

03_1703_28

9

[Jan. 14]

Lower & Upper Motor

Neuronal Systems

iRA/tRA

Clinical

Application


Chapters 16-17; 20;

Laboratory Guide, Appendix

3

04_0104_16 &

04_2804_35

10

[Jan. 15]

Sectional Anatomy of

the Forebrain

iRA/tRA

Hands-On

Application

Laboratory Guide, Lab 501_2501_28;

06_18

11

[Jan. 19]

Modulation of

Movement

iRA/tRA

Clinical

Application


Chapters 18-19; Laboratory

Guide, Appendix 3

04_1704_27

12[Jan. 20]

Visceral Motor System iRA/tRAClinical

Application

Neuroscience, 5thEd.,Chapter 21

04_3604_43

13

[Jan. 21]

Associational Cortex of

the Temporal Lobe

iRA/tRA

Clinical

Application

Motor Learning

Experiment


Chapters, 26-27 & 31 (see

Learning Event description in

Bluedocs for annotations on

prioritizing reading

selections)

06_01, 06_02;

06_0506_09

14

[Jan. 22]

Sleep & Wakefulness;

Disorders of Cognition

iRA/tRA

Clinical

Applications


Chapters 28

Dr. Krtsyals new

video tutorials on

sleep and sleep

disorders

15

[Jan. 25]Early Brain Development

iRA/tRA

Neurobiology

Application


Chapters 22-23 (see Learning

Event description in Bluedocs

for annotations on


selections)

05_0205_12


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TUTORIALS

16

[Jan. 26]

Brain Development in

Childhood

iRA/tRANeurobiology

Application


Chapters, 8, 24-25 (see




selections)

02_1802_22;

05_1305_23

17

[Jan. 27]Emotion; Attention

iRA/tRA

Clinical &

Neurobiological

Applications


Chapters 26 & 29 (see




selections)

06_1806_24

18[Jan. 28]

Associational Cortex of

the Frontal & Parietal

Lobes; Stress &Anxiety; Reward &

Addiction

iRA/tRA

ClinicalApplication

Neuroscience, 5

th

Ed.,Chapter, 26

06_03, 06_04,

06_10, 06_11,06_23, 06_24

19

[Jan. 29]

Decision Making &

Executive Functions;

Future Horizons

Neurobiology

Application

review Neuroscience, 5thEd.,

Chapter 26n.a.

20

[Feb. 1]NBME Final Exam n.a. n.a. n.a.

Please note: topics and schedule are subject to change.

Documents

Brain and Behavior -- Syllabus